Epilepsy Flashcards
What is epilepsy?
Epilepsy is a neurological condition that affects the central nervous system, resulting in recurrent spontaneous seizures. It is caused by various etiologies and can be triggered by electrical, chemical, or mechanical stimulation.
How common is epilepsy?
Epilepsy is one of the most common CNS disorders, affecting about one in a hundred North Americans.
Why is it important for a massage therapist to understand epilepsy?
Carelessly applied manual techniques and hydro applications can destabilize control mechanisms in the brain and precipitate seizures. However, massage therapy can also be beneficial by providing relaxation, pain reduction, and injury rehabilitation.
What role does massage therapy play in managing epilepsy?
Massage therapy can help provide relaxation, reduce pain and physical stress, and assist in rehabilitation of injuries. However, certain elements of massage therapy can trigger seizures for some patients, so care must be taken to minimize such occurrences.
What are the key considerations for a massage therapist when treating an epileptic patient?
The therapist should:
• Obtain necessary case history information
• Determine when not to treat
• Adapt the treatment and environment
• Adjust the treatment plan to account for medications
• Respond appropriately if a seizure occurs
What is the definition of epilepsy?
Epilepsy is best defined as a neurological condition that affects the central nervous system, leading to recurrent spontaneous seizures, and is caused by various etiologies.
Can every brain be induced to have a seizure?
Yes, virtually every brain can be induced to seizure with sufficient electrical, chemical, or mechanical stimulation.
What percentage of the population will experience a seizure at some point in their life?
Seven to ten percent of the population will have a seizure at some point in their lifetime.
What are some situations where seizures can occur without the person being considered epileptic?
Seizures can occur due to high fever, drug and hormone reactions, intense sleep or nutritional deprivation, and electroshock therapy.
How is epilepsy diagnosed?
Epilepsy is diagnosed if a person has two unprovoked seizures or one unprovoked seizure with a high risk of more, such as within damaged, diseased, or vulnerable brain tissue, or in response to stimuli that wouldn’t cause seizures in a non-epileptic brain.
What is a seizure?
A seizure is a sudden onset, self-limiting episode of physical and/or psychological dysfunction caused by an abnormal burst of firing in the CNS. Symptoms are sudden and transient and can include motor, sensory, autonomic, and/or psychic phenomena. These indicate which part of the brain has been activated and often occur in a stereotyped pattern.
Where can the abnormal impulse that causes a seizure arise from?
The abnormal impulse can arise from anywhere within the cerebral cortex or deeper brain centers. It may remain localized or spread extensively throughout the brain.
Why are seizures self-limiting?
Seizures are self-limiting due to intrinsic inhibitory mechanisms within the CNS and because metabolic wastes accumulate, altering conditions for neuronal firing.
What is the term “ictus” and how is it used?
Ictus refers to seizure activity in the brain, and “ictal” is the adjective form used in medical literature related to epilepsy.
What is an irritable or epileptogenic focus?
An irritable or epileptogenic focus is a specific area in the brain, which may contain conditions like gliosis, an aneurysm, abnormal chemistry, or a tumor. This area causes spontaneous depolarization or acts as an irritant to nearby neurons, triggering abnormal firing and leading to a seizure.
Are irritable foci always present in epilepsy?
No, the presence of irritable foci is common but not always present in epilepsy. Some forms of epilepsy involve generalized abnormal firing from the outset.
What is an aura in the context of epilepsy?
An aura is a sensory hallucination experienced by some people with epilepsy before a seizure. It is considered a focal onset aware seizure (FAS), sometimes called a “warning.” Auras can precede other types of seizures.
What are some common symptoms of an aura?
Common aura symptoms include:
• Visual: Flashing lights, blurred vision, seeing things that aren’t there.
• Smell: Unpleasant smells like rotten eggs.
• Taste: Odd tastes like metal or bitterness.
• Sounds: Odd noises such as ringing or buzzing.
• Feelings: Emotions like sadness, joy, panic, or fear, as well as nausea or lightheadedness.
• Deja vu: An intense feeling of having experienced something before.
• Body: Stiffness, twitching, numbness, tingling, or changes in the sensation of body parts.
What is a trigger in the context of epilepsy?
A trigger is a stimulus, usually sensory, that produces activity in the abnormal brain area, pushing the neuronal tissue beyond its threshold and potentially leading to a seizure.
What are some common seizure triggers?
Common seizure triggers include:
• Specific time of day or night
• Sleep deprivation or disrupted sleep
• Illness (with or without fever)
• Flashing bright lights or patterns
• Alcohol (including heavy use or withdrawal)
• Drug use (e.g., cocaine, ecstasy)
• Stress
• Hormonal changes (e.g., menstrual cycle)
• Poor nutrition, dehydration, and low blood sugar
• Specific foods, excess caffeine, or products that aggravate seizures
• Missed medications
• Sensory stimuli like reading or listening to music
• Firing from muscle and joint receptors
What causes epilepsy?
Epilepsy can be caused by anything that damages, deranges, or disturbs neuronal function in the brain, leading to a lack of balance between excitatory and inhibitory influences on neurons, disturbing synchronous depolarization patterns.
How do excitatory and inhibitory influences contribute to epilepsy?
While most seizures result from excitation predominance (e.g., tonic-clonic seizure), inhibition predominance also occurs (e.g., absence seizures).
What populations have the greatest prevalence of epilepsy?
Epilepsy prevalence is greatest in the younger and older populations. Seizures begin before 18 in more than 75% of cases.
What happens to epilepsy incidence in adulthood?
Epilepsy often subsides in early to middle adulthood, with a relatively smaller incidence in the 30-50 age group. However, there is an increase in new diagnoses after age 50, often related to strokes, diabetes, and other organ pathologies.
How do heart failure and cardiac dysrhythmia relate to epilepsy?
Heart failure and cardiac dysrhythmia are associated with seizures as they can adversely affect blood/nutrient supply to the brain and clearance of toxic elements.
What impact can drugs have on epilepsy development?
Certain drugs that lower the seizure threshold can contribute to the development of epilepsy, especially in older age groups.
What are the common known causes of epilepsy?
Known causes of epilepsy include infections, autoimmune epilepsy, genetic factors, metabolic disorders, and structural brain abnormalities.
What infections can lead to epilepsy?
Infections that can lead to epilepsy include:
• Cerebral malaria
• TORCH infections (toxoplasmosis, rubella, cytomegalovirus, herpes simplex)
• Bacterial meningitis
• Viral encephalitis
• Tuberculosis
• HIV
How is autoimmune epilepsy associated with other conditions?
Autoimmune epilepsy is more likely in people with a history of autoimmune diseases, cancer, or first-degree relatives with autoimmune diseases.
How does genetics contribute to epilepsy?
Genetic epilepsy occurs when individuals inherit abnormal genes that increase the risk of seizures, especially in idiopathic generalized epilepsy cases.
What metabolic disorders are linked to epilepsy?
Metabolic disorders, such as Type 1 Diabetes, are associated with a higher likelihood of developing epilepsy, with Type 1 Diabetics being nearly three times more likely.
What structural brain causes are associated with epilepsy?
Structural causes include:
- Head trauma
- Stroke-related vascular injury
- Brain tumors
- Brain degenerative diseases (e.g., Alzheimer’s)
- Perinatal brain injury and malformations
What disorders are strongly associated with epilepsy?
Conditions strongly associated with epilepsy include cerebral palsy (30-50% of children with CP have epilepsy), intellectual disability, autism, learning disabilities (especially dyslexia), and psychiatric disorders (e.g., psychosis, depression, hyperactivity).
What histological changes occur during an epileptic seizure?
The abnormal firing surge in seizures reflects changes in synchronization and intensity of influences on neurons. This results from a heightened degree of facilitation and shifts in the balance of excitatory and inhibitory neurochemistry.
What role do sodium and potassium play in neuronal firing?
Neurons fire when the balance of resting potential is altered, causing sodium to flow into the cell and potassium to flow out. This activity leads to depolarization, which is necessary for conduction toward a synapse.
